This Type of Thinking Can Help with Depression

People who struggle with anxiety or depression often ruminate on negative thoughts, like past missteps or feelings that they’re not good enough. The secret to better mental health may be learning how not to dwell on these thoughts, according to new research by a group of British and Norwegian researchers.

Their study focuses on a technique called metacognitive therapy, or MCT, which was developed in Europe in the 1990s. MCT trains people to lessen the ruminative process, says study co-author Stian Solem, PhD, associate professor of psychology at the Norwegian University of Science and Technology.

In the United States and Europe, the current recommended treatments for depression and anxiety are medications and cognitive behavioral therapy, or CBT. Sometimes called talk therapy, CBT encourages people to analyze their negative thoughts and challenge whether they’re really true.

That’s what makes MCT different: Instead of drilling deeper into those thoughts, MCT helps people reduce negative thought processes and take control over them, says Solem.

Solem and his colleagues tested the MCT method in 20 patients with depression, who attended 10 therapy sessions over a 10-week period. The study also involved a control group of 19 people who were wait-listed for MCT, and receive no treatment for the first 10 weeks.

After those 10 weeks, about 80% of patients in the MCT group reported a full recovery from depression symptoms, based on a standard screening questionnaire. Anxiety symptoms also improved overall, and no patients reported worsening of their condition. In comparison, only about 5% of patients in the control group had a similar recovery.

Six months after completing MCT, recovery rates were similar, with only a few patients reporting relapses. Studies on CBT have shown that only 40% to 48% of patients are recovered after treatment, the authors write, and between 40% and 60% relapse within two years.

For a lot of people, the authors say, realizing that they don’t have to worry and ruminate about things can be quite liberating. They say MCT patients are often pleasantly surprised that they didn’t have to rehash all of their problems in their therapy sessions.

Smaller studies at the University of Manchester, where MCT was developed, have also shown that this method can be effective at treating depression—but this is the first published study to involve a control group. This helps support the theory that improvements are really from the therapy, and not just symptoms getting better on their own over time.

The researchers say a soon-to-be-published Danish study also found similar results. They hope that, with these findings, MCT becomes more popular in Norway and around the world.

MCT has not yet caught on in the United States, says Solem, and no U.S. practitioners are included in the MCT Institute’s online database of registered therapists. (The MCT Institute is in the process of developing self-help materials, its website states, but these aren’t yet available.) However, Solem says that the principles of MCT can be helpful for most people, even without formal training.

“Many of our patients have conflicted beliefs concerning worry and rumination,” Solem told Health in an email. “They experience that it is uncontrollable, exhausting, and dangerous—‘I can go mad,’ ‘I can make myself sick.’” At the same time, they think they need to ruminate in order to find answers and prevent danger.

“In MCT we often start out with postponing worry and rumination (which most people are able to do) and later we use something called detached mindfulness,” he says. “It involves being aware of the trigger thought, but choosing not to engage in it.”